The integration layer around your core system
Your core claims system does its job. Prismaid handles the feeds, files and regulatory APIs around it, in a tool your own team can run.
Where health plans use Prismaid
Enrollment
Parse 834 files and load them into your enrollment tables, and generate 834s for downstream partners.
Claims and remittance
Work with 837P, 837I, 837D and 835 files, plus 999 and 277CA acknowledgments, in flows you can schedule and monitor.
Medicare Advantage operations
Ingest monthly CMS files such as MMR, MODD, DTRR and LEPD, and reconcile them against each other.
Prior authorization and interoperability
Host the CMS-0057-F Prior Authorization API, and manage Provider Access and Payer-to-Payer operations alongside your FHIR platform.
See CMS-0057-F coverageProvider directory
Publish a public FHIR provider directory API based on the Da Vinci Plan-Net guide.
Why teams choose this approach
Your team owns the flows
Analysts can see and change what a flow does on a visual canvas, without waiting for a custom build.
Your infrastructure, your data
Deploy in your own data center or cloud account, including air-gapped networks.
Enterprise capability without the enterprise price tag
A single platform for healthcare formats, APIs and automation, priced for plans that don't want a large integration program.
Start with one feed
Tell us which file or API is causing the most work today, and we will show you what it looks like in Prismaid.